Peri-Procedural Anticoagulation and Imaging
Catheter ablation in patients treated with warfarin was performed without interruption. Patients treated with direct oral anticoagulants (DOACs) held anticoagulation for a maximum of 24 h prior to the ablation procedure, with resumption 4 h post-procedure. Anticoagulation was continued for a minimum of 3 months following ablation for all patients.
Patients underwent routine transesophageal echocardiography (TEE) immediately prior to ablation to exclude LAA thrombus unless TEE was clinically contraindicated. Patients unable to undergo preprocedural TEE were systemically anticoagulated for at least one month prior to ablation. Additionally, patients underwent pre-procedure cardiac CT or MRI to delineate left atrial anatomy. Electroanatomic mapping (EAM) data collected during the procedure was merged with the pre-acquired CT or MRI at the operator’s discretion.